Background: Alcoholic liver disease (ALD) includes a wide clinical spectrum from acute alcoholic hepatitis to severe cirrhosis and/or hepatocellular carcinoma. Until now, there has been no report revealing the bleeding tendency of ALD compared to other diseases in liver transplantation (LT). Thus, we analyzed blood loss and transfusion amounts during operation according to the etiologies of liver disease and model for end-stage liver disease (MELD) score. Methods: Out of 874 recipients who underwent LT, a total of 146 patients were excluded by our exclusion criteria. We compared 728 recipients’ baseline characteristics, operation time, blood loss, and transfusion amounts between ALD and nonALD according to MELD score. Results: The number of patients in the ALD group was 130 (17.9%), and 598 (82.1%) in the non-ALD group. The ALD group showed younger age, higher MELD score, and a higher proportion of deceased donor LT than the non-ALD group. Intraoperative blood loss and transfusions of red blood cells (RBCs), fresh frozen plasma, and platelets were significantly higher in the ALD group. When stratified by MELD score (cut-off: 20), ALD patients in both high and low MELD subgroups demonstrated greater blood loss and RBC transfusion requirements, even when international normalized ratio and platelet counts were similar. In multivariate logistic regression analysis, ALD was a significant risk factor for massive transfusion (odds ratio 1.813, 95% confidence interval 1.158–2.840, p=0.009). Conclusion The ALD group showed increased bleeding tendency than the non-ALD group during LT, irrespective of MELD score. This suggests that transplant surgeons should anticipate greater blood loss and ensure adequate transfusion resources during LT for ALD patients.

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

Purpose: The purpose was to compare shear bond strength (SBS) of three types of resin for temporary restoration to polyetherketoneketone (PEKK) depending on surface modification. Materials and Methods: Sixty disks made from PEKK were air-abraded with 110 μm alumina particles (Cobra, Renfert GmbH, Hilzinge, Germany) and thirty specimens were divided into two groups each:PEKK without Visio.link (Bredent, Senden, Germany)(U) and with Visio.link (P). Resins for temporary restoration (polymethylmethac-rylate; PMMA, polyethylmethacrylate; PEMA, bis-acryl composite resin) in the shape of a square with one side 3.2 mm were bonded to PEKK twenty respectively and classified into six groups (UM, UE, UC, PM, PE and PC). All specimens were stored in distilled water at 37°C for 24 hours. SBS of each group was measured at a crosshead speed of 2 mm/min in universal testing machine. SBS was compared using one-way ANOVA and a Tukey HSD test (P = 0.05). Results: Group UM and group UE showed a significant difference in SBS with group UC (P < 0.05). Group PC showed a significant increase in SBS than group UC (P < 0.05). Conclusion It is recom-mended to apply Visio.link to PEKK for adhering bis-acrylic composite resin, but not for PMMA and PEMA in clinical practice.

Treatment options for edentulous patients are complete denture and implant prosthesis. A two implant-retained overdenture can be considered the first treatment in the edentulous mandible, but there is no clear consensus of treatment for edentulous maxilla. Implant-retention/support overdenture shows better retention and stability than complete denture and is less expensive and more esthetic than implant-supported fixed prosthesis. CM LOC® Pekkton® attachment is a solitary type attachment and evaluated to have excellent abrasion resistance and retention with a female part made of poly-ether-ketone-ketone. Meanwhile, SR Ivocap system is injection molding method and discussed to show few changes in the vertical dimension of denture and have excellent fracture resistance. In this case, we restored maxillary arch with a four implant-retained overdenture using CM LOC® Pekkton® and SR Ivocap system, and mandibular arch with a removable partial denture. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.
Consensus ; Denture, Complete ; Denture, Overlay ; Denture, Partial, Removable ; Dentures ; Female ; Fungi ; Humans ; Mandible ; Maxilla ; Methods ; Prostheses and Implants ; Vertical Dimension

We analyzed the genetic diversity of Cylindrocarpon destructans isolates obtained from Korean ginseng (i.e., Panax ginseng) roots by performing virulence tests and nuclear ribosomal gene internal transcribed spacer (ITS) and mitochondrial small subunit (mt SSU) rDNA sequence analysis. The phylogenetic relationship analysis performed using ITS DNA sequences and isolates from other hosts helped confirm that all the Korean C. destructans isolates belonged to Nectria/Neonectria radicicola complex. The results of in vivo and ex vivo virulence tests showed that the C. destructans isolates could be divided into two groups according to their distinctive difference in virulence and the genetic diversity. The highly virulent Korean isolates in pathogenicity group II (PG II), together with foreign isolates from P. ginseng and P. quinquefolius, formed a single group. The weakly virulent isolates in pathogenicity group I, together with the foreign isolates from other host plants, formed another group and exhibited a greater genetic diversity than the isolates of PG II, as confirmed by the mt SSU rDNA sequence analysis. In addition, as the weakly virulent Korean isolates were genetically very similar to the foreign isolates from other hosts, they were likely to originate from hosts other than the ginseng plants.
Base Sequence ; DNA, Ribosomal ; Genetic Variation* ; Panax* ; Sequence Analysis ; Virulence*

BACKGROUND AND OBJECTIVES: Hereditary hemorrhagic telangiectasia (HHT), often manifested as epistaxis, is also manifested in combination with serious comorbid diseases. The authors reviewed 12 cases of HHT and investigated the manifestations and comorbid diseases of HHT in the Korean population. SUBJECTS AND METHOD: Medical records of the HHT patients in our department from July 2004 to December 2011 were reviewed retrospectively. Twelve patients who had been classified as definite or possible HHT according to the Curacao criteria were enrolled in this study. Clinical manifestations, treatment methods, results, and comorbid diseases were investigated. RESULTS: Recurrent epistaxis occurred in 100% of the patients. Epistaxis was managed by bipolar or laser cauterization (n=9), embolization of the feeding vessel (n=1), intranasal application of bevacizumab (Avastin(R))(n=2) or septodermoplasty (n=1). The symptoms of seven patients showed much improvement while the other two did not. Comorbid diseases included pulmonary arteriovenous malformation (AVM) in 5 patients (41.7%) and cerebral AVM in 2 patients (16.7%). Three patients with pulmonary AVM received embolization and one patient with cerebral AVM received gamma knife surgery with good prognosis. CONCLUSION: Epistaxis by HHT can be improved by active treatment using various methods. Pulmonary and cerebral AVMs are common comorbid diseases and should be considered in the management of HHT.
Antibodies, Monoclonal, Humanized ; Arteriovenous Malformations ; Comorbidity ; Epistaxis ; Glycosaminoglycans ; Humans ; Medical Records ; Retrospective Studies ; Telangiectasia, Hereditary Hemorrhagic ; Vascular Malformations ; Bevacizumab

We have successfully applied the nested PCR to detect Cylindrocarpon destructans, a major pathogen causing root rot disease from ginseng seedlings in our former study. The PCR assay, in this study, was used to detect the pathogen from soils. The nested PCR using internal transcribed spacer (ITS) 1, 4 primer set and Dest 1, 4 primer set maintained the specificity in soils containing various microorganisms. For a soil DNA extraction method targeting chlamydospores, when several cell wall disrupting methods were tested, the combination of lyophilization and grinding with glass beads, which broke almost all the chlamydospores, was the strongest. The DNA extraction method which was completed based on the above was simple and time-saving because of exclusion of unnecessary stages, and efficient to apply in soils. As three ginseng fields whose histories were known were analyzed, the PCR assay resulted as our expectation derived from the field information. The direct PCR method will be utilized as a reliable and rapid tool for detecting and monitoring C. destructans in ginseng fields.
Cell Wall ; DNA ; Freeze Drying ; Glass ; Panax ; Polymerase Chain Reaction ; Seedlings ; Sensitivity and Specificity ; Soil

BACKGROUND: Nerve ligation injury may produce mechanical allodynia, but this can be reversed after an intrathecal administration of adenosine analogues. In many animal and human studies, ATP-sensitive potassium channel blockers have been known to reverse the antinociceptive effect of various drugs. This study was performed to evaluate the mechanical antiallodynic effects of spinal R-PIA (Adenosine A1 receptor agonist) and the reversal of these effects due to pretreatment with glibenclamide (ATP-sensitive potassium channel blocker). Thus, the relationship between the antiallodynic effects of R-PIA and ATP-sensitive potassium channel were investigated in a neuropathic model. METHODS: Male Sprague Dawley rats were prepared by tightly ligating the left lumbar 5th and 6th spinal nerves and implantation of a chronic lumbar intrathecal catheter for drug administration. The mechanical allodynia was measured by applying von Frey filaments ipsilateral to the lesioned hind paw. And the thresholds for paw withdrawal assessed. In study 1, either R-PIA (0.5, 1 and 2microgram) or saline were administered intrathecally for the examination of the antiallodynic effect of R-PIA. In study 2, glibenclamide (2, 5, 10 and 20 nM) was administered intrathecally 5 min prior to an R-PIA injection for investigation of the reversal of the antiallodynic effects of R-PIA. RESULTS: The antiallodynic effect of R-PIA was produced in a dose dependent manner. In study 1, the paw withdrawal threshold was significantly increased with 2microgram R-PIA (P < 0.05). In study 2, the paw withdrawal threshold with 2microgram R-PIA was significantly decreased almost dose dependently by intrathecal pretreatment of 5, 10 and 20 nM glibenclamide (P < 0.05). CONCLUSIONS: These results demonstrated that an intrathecal injection of ATP-sensitive potassium channel blockers prior to an intrathecal injection of adenosine A1 receptors agonist had an antagonistic effect on R-PIA induced antiallodynia. The results suggest that the mechanism of mechanical antiallodynia, as induced by an intrathecal injection of R-PIA, may involve the ATP-sensitive potassium channel at both the spinal and supraspinal level in a rat nerve ligation injury model.
Adenosine ; Animals ; Catheters ; Glyburide ; Humans ; Hyperalgesia ; Injections, Spinal ; Ligation ; Male ; Neuralgia ; Potassium Channel Blockers ; Potassium Channels* ; Potassium* ; Rats* ; Rats, Sprague-Dawley ; Receptor, Adenosine A1 ; Receptors, Purinergic P1 ; Spinal Nerves

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasm in late life. The most common benign tumor developed within the nevus is syringocystadenoma papilliferum and the most common malignant tumor basal cell epithelioma. Although two different tumors often develop simultaneously on the lesion, it is rare to see more than two different tumors developing on the lesion of nevus sebaceus. In Korean literatures only three such cases were reported. We report an additional case of nevus sebaceus developing three different tumors, syringocystadenoma papilliferum, sebaceous epithelioma, and basal cell carcinoma, in a 67-year-old female patient.
Aged ; Carcinoma* ; Carcinoma, Basal Cell* ; Female ; Hamartoma ; Humans ; Nevus*

Spontaneous spinal epidural hematoma is a rare entity. Various definitions for spontaneous epidural hematoma have been reported in the literature. The expression of nontraumatic spinal epidural hematoma seems to be less ambiguous and includes idiopathic hematomas and hematomas secondary to coagulopathy, vascular malformations, and tumors. We report three cases of nontraumatic spinal epidural hematomas observed from 1991 to 2000. The causes of the spinal epidural hematomas were not clear in two cases among them, but in the another one case, the cause was determined to be an acquired coagulopathy. We reviewed 24 cases reported in the Korean Journal of Neurosurgery and our three cases with particular emphasis on the various causes such as coagulopathy, vascular malformations and tumors. Among the 27 cases, numerous causes were detected such as three cases of vascular malformation, one case of anticoagulant treatment, five cases of combined lumbar disc herniation, two cases associated with pregnancy and postpartum, one case associated with hypertension, and one case associated with ossification of ligamentum flavum. No causes were detected in the ten cases. The authors reviewed the literature.
Hematoma ; Hematoma, Epidural, Spinal* ; Hypertension ; Ligamentum Flavum ; Neurosurgery ; Postpartum Period ; Pregnancy ; Vascular Malformations